Social influences on smoking cessation in mid-life: Prospective cohort of UK women

Autoři: Jaime L. Martin aff001;  Isobel Barnes aff002;  Jane Green aff002;  Gillian K. Reeves aff002;  Valerie Beral aff002;  Sarah Floud aff002
Působiště autorů: Faculty of Medicine, Dentistry and Health Sciences, Melbourne University, Melbourne, Victoria, Australia aff001;  Cancer Epidemiology Unit, Nuffield Department of Population Health, University of Oxford, Oxford, United Kindom aff002
Vyšlo v časopise: PLoS ONE 14(12)
Kategorie: Research Article



Decisions to quit smoking are thought to be influenced by social factors such as friends, family and social groups, but there have been few attempts to examine comprehensively the influence of a range of social factors on smoking cessation. In the largest study to date, we examined whether smoking cessation was associated with marital status and the smoking habits of a partner, socio-economic status and social participation.


In the prospective Million Women Study, 53,650 current smokers in 2001 (mean age 58.3, SD 4.4) reported their smoking status 4 years later; and reported on social factors on both occasions. Logistic regression yielded odds ratios (ORs) and 99% confidence intervals (CIs) for stopping smoking in the next 4 years by marital status, whether their partner smoked, deprivation, education, and participation in social activities.


31% (16,692) of the current smokers at baseline had stopped after 4 years. Smokers who were partnered at baseline were more likely to quit than those who were not partnered (OR 1.13, 99% CI 1.06–1.19). Compared to having a partner who smoked throughout, those who had a non-smoking partner throughout were more likely to quit (OR 2.01, 99% CI 1.86–2.17), and those who had a partner who smoked at baseline but stopped smoking in the next 4 years were even more likely to quit (OR 6.00, 5.41–6.67). There was no association with cessation for education or deprivation. The association with social participation varied by type of activity but was null overall.


Women who were partnered were most likely to stop smoking if their partner also stopped smoking. There was little evidence of a strong influence of either socio-economic status or social participation on smoking cessation. These results emphasise the importance of a spouse’s smoking habits on the likelihood of a smoker successfully quitting smoking.

Klíčová slova:

Behavior – Cardiovascular diseases – Cardiovascular diseases in women – Hospitals – Questionnaires – Religious faiths – Smoking habits – Social influence


1. World Health Organization. Prevalence of tobacco smoking. Global Health Observatory Data [Internet]. 2015 01/05/2018. Available from:

2. Office for National Statistics. Adult smoking habits in the UK: 2016. 2017 01/05/2018. Available from:

3. Burns RJ, Rothman AJ, Fu SS, Lindgren B, Joseph AM. The relation between social support and smoking cessation: revisiting an established measure to improve prediction. Ann Behav Med. 2014;47(3):369–75. doi: 10.1007/s12160-013-9558-7 24222508

4. Husten CG, Chrismon JH, Reddy MN. Trends and effects of cigarette smoking among girls and women in the United States, 1965–1993. J Am Med Womens Assoc. 1996;51(1–2):11–8.

5. Pirie K, Peto R, Reeves GK, Green J, Beral V. The 21st century hazards of smoking and benefits of stopping: a prospective study of one million women in the UK. Lancet. 2013;381(9861):133–41. doi: 10.1016/S0140-6736(12)61720-6 23107252

6. Doll R, Peto R, Boreham J, Sutherland I. Mortality in relation to smoking: 50 years' observations on male British doctors. Bmj. 2004;328(7455):1519. doi: 10.1136/bmj.38142.554479.AE 15213107

7. Lam TH, Li ZB, Ho SY, Chan WM, Ho KS, Tham MK, et al. Smoking, quitting and mortality in an elderly cohort of 56,000 Hong Kong Chinese. Tob Control. 2007;16(3):182–9. doi: 10.1136/tc.2006.019505 17565138

8. Djikanovic B, Marinkovic J, Jankovic J, Vujanac V, Simic S. Gender differences in smoking experience and cessation: do wealth and education matter equally for women and men in Serbia? J Public Health (Oxf). 2011;33(1):31–8.

9. Floud S, Balkwill A, Canoy D, Reeves GK, Green J, Beral V, et al. Social participation and coronary heart disease risk in a large prospective study of UK women. Eur J Prev Cardiol. 2016;23(9):995–1002. doi: 10.1177/2047487315607056 26416995

10. Floud S, Balkwill A, Canoy D, Wright FL, Reeves GK, Green J, et al. Marital status and ischemic heart disease incidence and mortality in women: a large prospective study. BMC Med. 2014;12:42. doi: 10.1186/1741-7015-12-42 24618083

11. Hiscock R, Bauld L, Amos A, Fidler JA, Munafo M. Socioeconomic status and smoking: a review. Ann N Y Acad Sci. 2012;1248:107–23. doi: 10.1111/j.1749-6632.2011.06202.x 22092035

12. Holahan CJ, North RJ, Holahan CK, Hayes RB, Powers DA, Ockene JK. Social influences on smoking in middle-aged and older women. Psychol Addict Behav. 2012;26(3):519–26. doi: 10.1037/a0025843 22004130

13. Wilkinson RG, Marmot M. Social determinants of health. 2nd ed. ed. Oxford: Oxford University Press; 2006.

14. Nystedt P. Marital life course events and smoking behaviour in Sweden 1980–2000. Soc Sci Med. 2006;62(6):1427–42. doi: 10.1016/j.socscimed.2005.08.009 16162388

15. Margolis R, Wright L. Better Off Alone Than With a Smoker: The Influence of Partner’s Smoking Behavior in Later Life. J Gerontol B—Psychol. 2016;71(4):687–97.

16. Osler M, Prescott E. Psychosocial, behavioural, and health determinants of successful smoking cessation: a longitudinal study of Danish adults. Tob Control. 1998;7(3):262–7. doi: 10.1136/tc.7.3.262 9825421

17. Murray RP, Johnston JJ, Dolce JJ, Lee WW, O'Hara P. Social support for smoking cessation and abstinence: the Lung Health Study. Lung Health Study Research Group. Addict Behav. 1995;20(2):159–70. doi: 10.1016/s0306-4603(99)80001-x 7484310

18. Jackson SE, Steptoe A, Wardle J. The influence of partner's behavior on health behavior change: the English Longitudinal Study of Ageing. JAMA Intern Med. 2015;175(3):385–92. doi: 10.1001/jamainternmed.2014.7554 25599511

19. Lindstrom M, Isacsson SO, Elmstahl S. Impact of different aspects of social participation and social capital on smoking cessation among daily smokers: a longitudinal study. Tob Control. 2003;12(3):274–81. doi: 10.1136/tc.12.3.274 12958387

20. Green J, Reeves GK, Floud S, Barnes I, Cairns BJ, Gathani T, et al. Cohort Profile: the Million Women Study. Int J Epidemiol. 2019;48(1):28–9e. doi: 10.1093/ije/dyy065 29873753

21. Townsend P, Beattie A, Phillimore P. Health and deprivation: inequality and the North. London: Croom Helm; 1988.

22. Twardella D, Loew M, Rothenbacher D, Stegmaier C, Ziegler H, Brenner H. The diagnosis of a smoking-related disease is a prominent trigger for smoking cessation in a retrospective cohort study. J Clin Epidemiol. 2006;59(1):82–9. doi: 10.1016/j.jclinepi.2005.05.003 16360565

23. Pennanen M, Broms U, Korhonen T, Haukkala A, Partonen T, Tuulio-Henriksson A, et al. Smoking, nicotine dependence and nicotine intake by socio-economic status and marital status. Addict Behav. 2014;39(7):1145–51. doi: 10.1016/j.addbeh.2014.03.005 24727110

24. Moore S, Teixeira A, Stewart S. Effect of network social capital on the chances of smoking relapse: a two-year follow-up study of urban-dwelling adults. Am J Public Health. 2014;104(12):e72–6. doi: 10.2105/AJPH.2014.302239 25320891

25. Office for National Statistics. Adult smoking habits in Great Britain: 2017. 2018 09/09/2019. Available from:

26. Andersson P, Sjoberg RL, Ohrvik J, Leppert J. The effects of family history and personal experiences of illness on the inclination to change health-related behaviour. Cent Eur J Public Health. 2009;17(1):3–7. doi: 10.1007/s10389-008-0210-0 19418712

27. Gallus S, Muttarak R, Franchi M, Pacifici R, Colombo P, Boffetta P, et al. Why do smokers quit? Eur J Cancer Prev. 2013;22(1):96–101. doi: 10.1097/CEJ.0b013e3283552da8 22644233

28. Whitson HE, Heflin MT, Burchett BM. Patterns and predictors of smoking cessation in an elderly cohort. J Am Geriatr Soc. 2006;54(3):466–71. doi: 10.1111/j.1532-5415.2005.00641.x 16551314

Článek vyšel v časopise


2019 Číslo 12
Nejčtenější tento týden